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Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.

Kanury Rao of International Centre for Genetic Engineering and Biotechnology in India is testing small molecule inhibitors of host proteins required for M. tuberculosis to survive and replicate within host cells. Identifying and optimizing compounds that target host proteins could lead to new drug therapies for tuberculosis that are effective even against multidrug-resistant bacterial strains. This grant was selected through India's IKP Knowledge Park and their IKP-GCE program.

K. Ganesan and Pradip Sen of the Council of Scientific & Industrial Research - Institute of Microbial Technology in India will work to selectively kill cells latently infected with HIV by engineering reagents that would initiate killing only upon specific binding to proviral DNA. If successful, further development could result in a possible cure for latent HIV, which is thought to block the ability of anti-retroviral drugs to fully eradicate the disease. This grant was selected through India's IKP Knowledge Park and their IKP-GCE program.

Sanjiban Banerjee and Sambuddha Ghosh at AbGenics LifeSciences Pvt. Ltd in India will develop a new method to treat intestinal worm (helminth) infections using modified probiotic strains of the bacterium Lactobacillus. Lactobacillus, which can live in the human gut, will be modified to produce stable RNA molecules selected to target specific helminth genes and ultimately destroy the parasite, thereby curing the infection. Because Lactobacillus colonizes the gut, it can be used as a long-term treatment for multiple helminth infections. Efficacy of the approach will be tested in hamster and rabbit models of intestinal worm infections. This grant was selected through India's IKP Knowledge Park and their IKP-GCE program.

Kouichi Hasegawa of the Institute for Stem Cell Biology and Regenerative Medicine in India will develop an assay using human liver cells to study the parasite Plasmodium vivax, which causes malaria, and to screen for new anti-malarial drugs. During the parasitic life cycle inside human hosts, P. vivax infects hepatocytes (liver cells), where it can lie dormant and protected from treatment, leading to disease relapse. To identify new drugs to target this stage of P. vivax requires large numbers of human liver cells, which are difficult to obtain and often unsuitable. A new approach will be used to generate human hepatocytes by isolating a type of white blood cell from individuals infected with P. vivax, and inducing them to differentiate into hepatocytes, which should better support parasite growth. Once validated, this P. vivax liver-stage culture system will be used in a preliminary screen of a set of chemical compounds to identify new anti-malarial drugs. This grant was selected through India's IKP Knowledge Park and their IKP-GCE program.

Debjani Paul, Ninad Mehendale and Ammar Jagirdar from the Indian Institute of Technology Bombay in India will develop a simple system to detect sickle cell disease for use by untrained individuals in tribal populations in India in order to reduce infant mortality rates. Current diagnostics require expensive equipment and trained personnel, and are often inaccessible to the rural populations most in need. They will produce a microfluidic chip that can preserve a sample of blood in the deoxygenated environment required to maintain its characteristic sickle-shape, which can then be detected by a modified mobile phone camera and automated software that they will also develop. The system will be tested for sensitivity and specificity using blood from patients with sickle cell disease. This grant was selected through India's IKP Knowledge Park and their IKP-GCE program.

Saleem Mohammed of XCode is developing a platform for publishing, through which "health signals" will be delivered. These health signals are delivered over a subscriber's mobile phone in a snack format comprised of a reminder system through SMS, a reply mechanism for confirmation, a 1-minute audio clip that educates about the disease, and a quiz for engagement and incentives to be awarded accordingly. The SMS acts as a teaser to the audio clip that expands and goes into greater detail about TB drug adherence. The technology is deployed in the cloud, which enables the solution to scale rapidly and dynamically. REAP TB also uses the services of TB survivors for counseling and following up with TB patients.

Shashank Garg and team will develop a mobile solution that addresses problems in adherence to TB treatment through the key technologies of mobile phone-based electronic forms, workflow management, identity management, and electronic health records. The objective is to achieve automated tracking and monitoring of individual TB patients for adherence to the TB treatment protocol. ASHA workers will use the mobile application for collection of dosage intake data in the field. A workflow system will provide a closed loop through SMS alerts in case a patient defaults. Along with identity management and a TB treatment record, the system will ensure patients are able to seek treatment even on migration, thus maintaining continuity of treatment. This mobile solution is novel because it will use a form-based mobile application capable of running in disconnected or offline mode, with data connectivity being required only for the duration of data upload to the server.

Avin Agarwal and team will develop an electronic pill box with the software architecture based on a client-server software solution with hardware integration. The technique involves tracking the weight of the remaining pills through an electronic pill box with GSM connection and pressure sensor. This approach tracks if the pill is taken out of the pill box for consumption and reports this information to the central server. The solution could be as effective as DOT and a lot cheaper to implement. Addressing the cost of implementation will be emphasized for long-term execution, and an alternate SMS-based solution is suggested to reduce the dependency on pill boxes, in case the objective can be met using a less expensive SMS solution. By the nature of its design, the application will identify defaulters and escalate them for more stringent techniques of monitoring and at the same time alert healthcare professionals only when necessary.

Shweta Roy and team are developing a small, electronic, tablet strip holder that enables real-time tracking of patient treatment adherence and inventory. The tablet strip holder will be small in size, embedded with a weighing scale to monitor change in weight of tablet strips and thereby monitor treatment adherence. Any change in the weight of the strip will be recorded on a server via SMS using a telemetric SIM within the holder. If the change in weight is not detected within a given time period, the device will trigger a non-compliance alert through SMS to the patient and caregiver DOTS observer. The holder will also have an inbuilt alarm to alert the patient in case of missed dosages. The final product will be light weight and sleek in design and the patient will be able carry the tablet strip holder like a mobile phone. Minimal patient input is expected, making this device user friendly, and alerts can be customized as per regional language. The cost of the final device is expected to be $10 - 12 USD per piece.

Nishant Kumar and team are building a mobile hardware app which can serve an electronic pill box and can be attached to a conventional mobile phone. The hardware attachment has a rectangular sleek design, which can be fixed onto the mobile phone or can be used separately. A mobile application runs on the phone and controls the hardware attachment via Bluetooth. This product also facilitates a novel points-based incentives system to further encourage the patient towards continued adherence. A complementary mobile phone application runs on the handheld devices of the health worker. The hardware attachment can either be distributed as a standalone product or with a phone.

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